A Bexar County jury sentenced a Gloria Proo to 88 years and a fine of $10,000 on Tuesday.
Proo, 52, was found guilty on one count of injury to a child Monday afternoon. She was 5-year-old Josiah Williams' step-grandmother.
The child died two days after Christmas in 2012. He was abused, neglected and malnourished.
Three people were charged in this case. Among them is, Josiah's stepmother, Crystal Williams. She pleaded guilty to injury to a child, a first-degree felony.
KENS 5 sat in court last June to hear the chilling testimonies, as Williams awaited her fate.
"Josiah's cause of death is listed as 'dehydration in a battered, underweight child'," said Dr. Samantha Evans of the Bexar County Medical Examiner's office. Evans performed the autopsy on Josiah.
Tears and sobs filled the courtroom as the jury was played a video showing paramedics examining 5-year-old Josiah Williams after they found him dead inside of a southeast-side home.
Investigators said the boy suffered months of abuse at the hands of his stepmother, Crystal Williams, his father, Charleston Williams, and step-grandmother, Gloria Proo.
"The young man was very thin in appearance where you could see lots of bone structures from the outside," said Evans.
Crystal Williams was the first of the trio to stand trial.
"He also had a number of injuries ranging from what appeared to be acute injuries, things that happened very recently, to wounds that were in the process of healing, as well as a number of scars beyond what we typically see in a 5-year-old that comes through our office," said Evans.
The video, taken by the crime scene investigator at the time, Sgt. Matt Overton, also took jurors on a tour of the home where the abuse happened.
Investigators found a hole in the closet wall at the home, matching the size of Josiah's head, and traces of blood nearby.
The autopsy report shows multiple cuts and bruises all over his body, and a final weight of 38 pounds. Evans said they found no traces of drugs in Josiah's system.
Robert Johnson, a paramedic with the City of San Antonio, was part of the team of first responders to find Josiah. Johnson said Josiah wasn't breathing, and the 5-year-old didn't have a pulse. In the paramedic's report, he said Josiah was found laying on top of a blanket on the floor wearing shorts and underwear, soaked in urine.
After finding Josiah, Johnson also took note of his father's response after paramedics asked what happened.
"Father states, '[Josiah] fell last night but was fine earlier this morning'," said Johnson, reading from his 2012 report.
Josiah's brother and sister also lived in the home. They were removed by Child Protective Services, but investigators never said they were abused.
On the Child Advocates of San Antonio (CASA) Facebook page, the organization has an album dedicated to Josiah's memorial held at Natural Bridge Caverns the month after his death.
The caption to the album reads, "Because Josiah's siblings were removed from their home under a protective order, and their parents were then arrested and charged with injury to a child, Josiah's brother and sister were not permitted to attend the formal funeral the family members arranged."
One of the pictures shows Josiah's siblings sitting side by side at a picnic table. The caption reads, "One single cupcake was left on a picnic table for Josiah by his brother in hopes he would "enjoy it in heaven".